Distance Learning During the War in Ukraine: Experience of Internal Medicine Department (Organisation and Challenges)

Abstract

The beginning of the military aggression by the Russian Federation induced the suspension of education at all levels. Starting from March 14th, the training has continued in a remote format. But, although all educational institutions had the experience of distance learning, teaching during the war revealed its own features. During the war in Ukraine, health care facilities remain a military target, causing casualties among medical personnel. This, together with medical workers` abduction and migration, resulted in a shortage of medical staff. Under such conditions, the contribution of senior students and higher medical institution graduates was significant. Therefore, the continuation of medical education during the war is of great importance for an effective health care system functioning.
 The aim. Highlight the experience of distance learning organisation at the clinical department during the war and the problems were discovered during the class.
 Materials and methods. Classes were held daily with the mandatory synchronous and asynchronous parts, and the organisational component ensured their connection. The asynchronous component was organised by answering an extended clinical case, which included several theoretical questions and five mandatory tasks. To decrease the load for the teacher, the time limit for answering clinical case has been set, and a template of standard comments has been created. In addition, students were required to answer KROK2 tests. The synchronous component of distance learning was implemented using a Google Meet video conference, held daily according to a pre-approved schedule. In order to increase the level of student's communication skills, improve clinical thinking, as well as the practical application of the acquired knowledge, a "clinical" simulation was carried out during each video conference.
 Due to the pandemic of COVID-19, institutions of higher medical education had a well-established mechanism of the distance learning organisation. However, active hostilities on the territory of Ukraine led to additional obstacles. The lack of sufficient resources to meet the physiological needs limited the students' opportunities to study because, according to A. Maslow, the fulfilment of basic needs is important to an effective cognitive activity. The sound of air raid sirens required interrupting the online part and descending into a bomb shelter. A chronic shortage of basic needs realisation led to a disturbance of the emotional state and consequently hindered the effective processing and memorisation of the material. The absence of stable Internet and being in different time zones also interfered with efficient education. Students' participation in volunteer activities impeded their ability to engage in and concentrate on the educational process.
 Conclusions. Despite the sudden start of military aggression, institutions of higher medical education quickly switched to distance learning. As in the times of the COVID-19 lockdown, online education consisted of synchronous and asynchronous parts connected through the organisational component. However, active military operations and the constant threat of aerial attacks have created additional obstacles: security issues during the study, emotional state of students and teachers, problems with the Internet, power blackout, and being in different time zones. In addition, students` volunteer activities impeded full engagement in the learning process.

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